Shi Chenyi, Xiao Yuxi, Zang Dawei, Ren Hongjun
Department of Rehabilitation, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Department of Trauma, Beijing Water Conservancy Hospital, Beijing, China.
Int J Nurs Pract. 2025 Jun;31(3):e70020. doi: 10.1111/ijn.70020.
Treadmill training, including body weight-supported treadmill training (BWSTT), is widely used in stroke rehabilitation. However, its efficacy in improving walking outcomes may vary depending on patients' baseline functional status.
This study aims to systematically evaluate effectiveness of treadmill training on walking speed and endurance in stroke survivors and to assess influence of baseline dependency and use of BWSTT.
We performed systematic review and meta-analysis as per PRISMA 2020 guidelines. Comprehensive search was conducted using Scopus, MEDLINE, EMBASE, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, Cochrane Library, Google Scholar and ScienceDirect for studies published from January 1964 to April 2024. Eligible studies were randomized controlled trials assessing treadmill training in stroke patients with outcomes as walking speed and/or endurance. Data extraction and risk of bias assessment were independently performed by two reviewers using Cochrane Risk of Bias-2 tool. Standardized mean differences (SMDs) and 95% confidence intervals (CIs) were calculated using random effects model. Subgroup analyses were conducted based on baseline dependency and BWSTT use.
Fifty-nine studies were included. Meta-analysis demonstrated significant improvements in walking speed (SMD = 0.255; 95%CI: 0.141-0.369) and walking endurance (SMD = 0.277; 95%CI: 0.134-0.421) among stroke survivors receiving treadmill training. Subgroup analysis revealed that independent participants experienced greater benefits in walking speed (SMD = 0.345) and endurance (SMD = 0.374) compared to dependent participants. Studies employing BWSTT reported enhanced outcomes relative to those without BWSTT. Moderate to high heterogeneity was observed, and publication bias was detected.
Treadmill training, particularly when combined with BWSTT, effectively enhances walking speed and endurance in stroke survivors.
跑步机训练，包括减重支持跑步机训练（BWSTT），在中风康复中被广泛应用。然而，其在改善步行结果方面的疗效可能因患者的基线功能状态而异。
本研究旨在系统评估跑步机训练对中风幸存者步行速度和耐力的有效性，并评估基线依赖程度和BWSTT使用情况的影响。
我们按照PRISMA 2020指南进行了系统评价和荟萃分析。使用Scopus、MEDLINE、EMBASE、中国生物医学文献数据库、中国知网、Cochrane图书馆、谷歌学术和ScienceDirect对1964年1月至2024年4月发表的研究进行了全面检索。符合条件的研究为随机对照试验，评估中风患者的跑步机训练，结果为步行速度和/或耐力。两位评价者使用Cochrane偏倚风险-2工具独立进行数据提取和偏倚风险评估。使用随机效应模型计算标准化均数差（SMD）和95%置信区间（CI）。根据基线依赖程度和BWSTT使用情况进行亚组分析。
纳入59项研究。荟萃分析表明，接受跑步机训练的中风幸存者的步行速度（SMD = 0.255；95%CI：0.141 - 0.369）和步行耐力（SMD = 0.277；95%CI：0.134 - 0.421）有显著改善。亚组分析显示，与依赖参与者相比，独立参与者在步行速度（SMD = 0.345）和耐力（SMD = 0.374）方面受益更大。采用BWSTT的研究报告的结果相对于未采用BWSTT的研究有所改善。观察到中度至高度异质性，并检测到发表偏倚。
跑步机训练，特别是与BWSTT相结合时，能有效提高中风幸存者的步行速度和耐力。
